JPH03140161A - Inserting implement of excretion treatment device - Google Patents

Abstract

PURPOSE:To smoothly suck and eliminate even excretions containing a solid body, and to prevent the implement from falling out in the course of performing a treatment and a leak of the excretions by providing a flexible means for moving forward and backward a vibration part consisting of a vibrator and a horn. CONSTITUTION:A flexible means 24 is provided on a tapered part between a base end part of a protective cover 3 and a tip part of a body case 25 in which an O-ring 11 is interposed, and designed to a mechanism in which the tip part of a horn 1 stops at this side of the O-ring, when it is expanded to the maximum. In the crushing and suction process, a solid body 35 such as a seed, etc., mixed in excretions 34 is accumulated gradually in the vicinity of the tip part of the horn. When the accumulation becomes dense, a suction from a suction line declines. At this point, by depressing a stop lever 28, a stop to a notch groove 27 is released, and by drawing the body case 25 to this side, a vibration part consisting of a vibrator 2 and the horn 1 is moved backward. Subsequently, a state that the flexible means 24 is expanded to the maximum is formed, and in this state, a suction hole 8 is enlarged, and the solid body 35 such as a seed, etc., passes through easily, and sucked and eliminated smoothly and quickly.

Description

[Detailed Description of the Invention] [Field of Industrial Application] The present invention is a device that is inserted into the rectum of a patient who has difficulty defecating, and efficiently and safely crushes and suctions feces through ultrasonic mechanical vibration. The present invention relates to an insertion tool for an excretory disposal device that is removed from the body.

(Prior Art) As the population ages, the number of elderly people who are bedridden is increasing. Although the disposal of excrement is a major problem in daily life for these people, urine collection devices have only been developed as excretion devices, and diapers are still generally used. This is the current situation. but,
Wearing diapers causes great mental pain to patients, and the physical and mental burden of changing diapers on caregivers is also excessive, making it a serious problem for the elderly who are bedridden.

In addition, for fecal excretion treatment, methods are usually used to encourage defecation using laxatives, enemas, anal stimulation, etc., depending on the patient's constipation status. , disimpaction, suppositories, etc. are used alone or in combination.

However, these methods have the following problems.

(1) When high-pressure enema is applied to a patient whose stool is hard, it takes a long time and the patient cannot completely defecate, causing great pain to the patient.

(2) The dissection method involves wearing internal examination gloves and inserting a finger directly through the patient's anus to scrape out the stool. When the stool is hard, it becomes difficult to insert the finger into the rectum; In some cases, there is a risk of injuring the rectal mucosa. Moreover, it is an extremely unpleasant task that causes embarrassment to the patient and is accompanied by a strong odor for the operator.

(3) Although the method using suppositories is effective for mild constipation, it is hardly effective for patients with hard stools.

As described above, conventional defecation disposal methods cause great physical and mental pain to the patient and the person performing the defecation procedure, and also sometimes damage the rectal mucosa, leading to the risk of bleeding, infection, etc. .

As a means to solve the above-mentioned problems, the present inventors have developed an excretion processing device that efficiently crushes and suctions feces in the rectum using ultrasonic waves or audible vibrations (Japanese Patent Application Laid-Open No. No. 1-198540, Jitsugan Sho 63-
No. 64020, Japanese Patent Application No. 63-323359, Special Application No. 1983
No. 3-326041) a [Problem to be Solved by the Invention] The conventional insertion device attached to the above-mentioned excretion treatment device has a configuration shown in FIG. 3.

The main body consists of a protective cover 3 with a horn 1 set in the narrow diameter straight part at the tip and a built-in vibrator 2 in the wide diameter part at the rear. A suction near pull 4 for suctioning and removing collected feces, etc., an irrigation nipple 6 and a cable 7 are installed on the back cover 5 at the rear end. The protective cover 3 is intended to prevent the ultrasonic vibrating horn from coming into contact with the anus or rectal wall. An O-ring 9 for preventing feces from flowing into the vibrator 2 side, and an O-ring 11 for holding the vibrator are interposed at a position upstream of the fixing plate 10 of the vibrator 2. The vibrator 2 is composed of an electrostrictive vibrator or a magnetostrictive vibrator, but when it is an electrostrictive vibrator, it is usually made of PZT (
(Lead zirconate ditanate) is used, and a one-way bolt-tight Langevin transducer structure is adopted.
The shape of the tip of the horn 1 is as shown in the front view (a) and cross section (b) as shown in FIG.
These ejection holes 12 communicate with irrigation holes 13.

In use, the suction near pull 4 of the insertion tool and the storage container 15 connected to the suction pump 14 are connected via the suction tube 16, as shown in the fifth section.
The vibrator 20 cable 7 is connected to an ultrasonic oscillator 817 for supplying high-frequency power, and the irrigation nipple 6 is connected to a cleaning liquid container filled with a cleaning liquid such as an enema that is isotonic or harmless to the living body, such as physiological saline. 18 is connected by an irrigation tube 21 via an irrigation pump 19 and a preheater 20. Then,
Insert the narrow-diameter straight part of the insertion tool into the rectum from the anus, and pump the saxophone pump 14 and oscillate while feeding the cleaning fluid! Activate 1S17.

In this state, the tip of the horn vibrates at high speed, and at the same time, the finely divided cleaning liquid is ejected in the form of a jet onto the feces number 2 that is in contact with it.

Based on the above-described mechanism, hard feces are crushed and suctioned into the storage container 15 through the suction tube 6.

However, the following practical drawbacks were observed in the inserter having the above structure.

(1) The dietary habits of patients with defecation disorders do not necessarily consist of liquid foods, and it is customary for them to consume the same foods as healthy people. For this reason, for example, when seeds of watermelon, pear, apple, etc. are swallowed, these seeds are not digested and reach the rectum mixed with feces. However, solid substances such as seeds are not crushed by ultrasonic vibration, which hinders smooth discharge. Further, even if the emulsified feces is sucked in its original form along with the emulsified and liquefied feces, it will accumulate in the vicinity of the suction hole 8 one after another, causing problems in continuous crushing and suction removal of the feces.

This situation can be alleviated to some extent by increasing the diameter of the narrow straight part that is inserted into the anus, but this widening increases the pain burden on the patient and allows seeds to pass through. It is impossible to enlarge the suction hole to that extent.

2) The narrow diameter straight part that is inserted into the rectum from the anus is formed with a smooth surface, but in order to make it easier to insert and remove at the beginning and end of treatment, a lubricant such as jelly is usually applied to the outer surface. The method used is to apply it to make it slippery.

However, with this type of lubricity improving means, on the other hand, the insertion tool is often easily pulled out of the anus due to changes in the patient's position during treatment, causing a situation where continuous defecation treatment is not possible.

(3) Normally, the insertion tool inserted into the anus is tightly tightened by the action of the sphincter muscle to prevent fecal components from leaking out. However, in patients with deteriorating muscle strength, especially those with neuromuscular disease, the sphincter muscle function is extremely poor or is often absent, resulting in liquefied feces leaking from the gap between the anus and the insertion tool. A situation occurs. This phenomenon becomes more pronounced when there is a large amount of gas generated in the rectum, and the bed becomes dirty and a foul odor is generated, which becomes intolerable for the patient and the nurse.

The purpose of the present invention is to solve the above-mentioned problems, to be able to smoothly suction and remove feces containing solid substances such as seeds, and to prevent removal and fecal leakage during treatment. The present invention provides an insert for an excretory disposal device.

[Means to solve the problem]

To achieve the above object, the present invention is an insertion tool for an excretory disposal device that inserts a horn that vibrates mechanically using ultrasonic waves into the rectum through the anus to crush and suction remove feces. The main structural feature of this system is the provision of telescopic means for moving the vibrating section, which is comprised of a vibrator and a horn, installed in the system back and forth.

Furthermore, in the above configuration, the second feature is a structure in which a gas-liquid expandable ring-shaped balloon is installed at the outer circumferential position of the protective cover to be inserted into the anus, and immediately before the suction nipple at the outer circumference of the protective cover, The third feature is a structure in which a trapezoidal ring-shaped band is installed at the tip side of the horn.

[Function] According to the structure of the present invention, since the vibrating part consisting of the vibrator and the horn installed in the system of the insertion tool is provided with a mechanism that moves back and forth by the elastic means, the content in feces is removed during the treatment. When solid matter such as seeds accumulates near the tip of the horn, the vibrating section is moved back and the suction passage is enlarged, so that solid matter such as seeds can be suctioned away smoothly and quickly through the suction tube.

Further, since the balloon placed on the outer periphery of the protective cover is firmly fixed to the anus and rectal walls, the insertion tool is effectively prevented from being pulled out from the anus regardless of the patient's positional changes. Furthermore, by providing a trapezoidal ring-shaped pad at the tip of the horn, the band comes into close contact with the buttocks outside the anus, thereby preventing feces from leaking outside.

Through this series of actions, it is possible to complete the excretion process safely, reliably, and within a short time without causing physical or mental pain to the patient, practitioner, or caregiver.

[Example] The present invention will be specifically described below based on the example shown in FIGS. 1 and 2. In addition, in FIGS. 1 and 2, the same reference numerals are given to the same components as in the conventional example diagrams (FIGS. 3 to 5) described above.

FIG. 1 is a partially cutaway longitudinal cross-sectional view showing the insertion tool of the present invention inserted into the rectum 23 through the anus 22, in which 1 is a horn, 2 is a vibrator, 3 is a protective cover at the tip, and 4 is the suction nipple, 5 is the back cover of the insertion JL, 6 is the irrigation nipple, 7 is the cable, 8 is the suction hole, 9 is the O-ring, 1O is the fixing plate, and 11 is the 0-ring. Each part is the same as in Fig. 3), and the tip of horn 1 is the same as in Fig. 3).
The shape can be the same as the conventional shape shown in the figure.

Reference numeral 24 denotes a telescoping means installed in a part of the taper between the proximal end of the protective cover 3 and the distal end of the main body case 25 where the O-ring l is interposed, and when the horn 1 is extended to the maximum.
It is designed to have an a structure in which the tip part of the ring stops before the O-ring 9. The structure of the extensible means 24 can be constituted by an appropriate extensible member such as a bellows or a bellows with a built-in spring, but in consideration of simplicity, operability, etc., a bellows shape is preferable. In addition, it is desirable to select a material that can withstand repeated expansion and contraction, and has excellent friction and heat resistance in consideration of contact with the ultrasonic vibrating horn root.A material that meets these requirements is , nylon, polyacecool, synthetic resins such as tetrafluoroethylene and trifluoroethylene, various rubbers such as silicone rubber, butyl rubber, isoprene rubber, fluorine rubber, and natural rubber. It is best to use fluorine rubber, which has excellent heat resistance.

On the outer surface of the rear protective cover 3 close to the 0-ring 9,
It is desirable to install one or more locking levers 28 which are locking mechanisms that lock into notch grooves 27 provided on the corresponding horn proximal end surfaces via springs 26. In this case, the cut groove 27 is installed at a position where the locking lever 28 fits when the horn 1 is in the most contracted state, and corresponds to a vibration amplitude node in the horn axis direction where ultrasonic vibrations are not transmitted. It is formed in the position where The material of the locking lever 28 is selected from materials that are resistant to corrosion by cleaning fluids, such as synthetic resin and stainless steel.

Reference numeral 29 denotes an air-liquid expandable link-shaped balloon placed on the outer periphery of the protective cover 3 to be inserted into the anus 22, more precisely at a position closer to the rectum 23 than the sphincter 30. The ring-shaped balloon 29 is a hollow structure made of an elastic material such as silicone rubber or latex, and is installed on the outer surface of the protective cover using adhesive, thread, a thin stainless steel band, or a combination thereof. Then, it is connected to a luer type connector 32 with a stopcock that can be connected to a syringe (not shown) or the like via a feeding/discharging tube 31 (for example, a vinyl chloride pipe) drawn out of the anus.

Reference numeral 33 denotes a trapezoidal ring-shaped pad installed at a position on the tip end side of the horn 1, immediately before the suction nipple 4 on the outer circumference of the protective cover 3. The band 33 is made of an elastic material such as silicone rubber or latex, and is fitted in such a way that it tightly adheres to the buttocks around the anus and can slide on the surface of the protective cover in an airtight manner.

The insertion tool of the present invention having the above configuration is used in the following manner (see also FIG. 1).

First, before treatment, the insertion tool is connected to the movable devices of each system as in FIG. 1, and a lubricant such as jelly is applied to the front surface of the protective cover 3 with the telescopic means 24 retracted. Next, insert the insertion tool directly from the patient's anus 22! 23, and the band 33 is brought into close contact with the outer buttocks of the anus. The connector 32 with a stopcock is connected to the syringe, and the amount of air or water is supplied to the ring-shaped balloon 2 through the supply/discharge tube 31.
9 and inflate it. In this state, the insert is securely attached to the patient's anal and rectal walls, and at the same time the pad 33
Combined with the adhesion effect, the leakage of feces is completely prevented. Therefore, even if the patient changes his or her body position during treatment, the insertion tool will not come out, and leakage of liquefied feces to the outside is effectively prevented.

Subsequently, cleaning fluid is supplied from the irrigation nip J6, and the oscillator 17 and the succinic pump I4 are activated. At this stage, the feces near the tip of the horn are crushed and emulsified by the mechanical vibrations and jet-like cleaning liquid, and the feces are liquefied and removed by suction through the suction hole 8. At the same time, the rectum 23 gradually contracts, pushing down the feces in the upper part of the rectum, and smooth fragmentation and suction removal progresses.

During the above crushing and suction process, solid matter 35 such as seeds mixed in the feces 34 gradually accumulates near the tip of the horn. The suction from this densely accumulated line and the suction line is reduced (this state can be determined by the indication of a vacuum needle, not shown).

At this point, push down the locking lever 28 and cut into the groove 27.
2, and pull the main body case 25 toward you to retract the vibrating section consisting of the vibrator 2 and the horn I.

By the above operation, the telescoping means 24 is extended to the maximum.
Form the state of the diagram. In this state, the suction hole 8 is enlarged,
Solids 35 such as seeds pass through easily and are smoothly and rapidly suctioned away.

If the content of solids is small, the treatment can be completed by the above operation, but if it is contained in a large amount, the operation to return to the state shown in Figure 1 and then to the state shown in Figure 2 is performed intermittently. 2
Repeat ~3 times to aspirate the solids completely.

After feces and solid matter are completely excreted in this manner, the connector 32 is opened, the ring-shaped balloon 29 is deflated, and the insertion tool is removed from the anus to complete the treatment.

(Effects of the Invention) As described above, according to the inserter of the excrement treatment device according to the present invention, there is no problem in processing feces containing solid matter such as seeds, which has been a problem with inserters of conventional structure. It can be suctioned out smoothly without any complications, and effectively prevents inconvenient situations such as the insertion tool being pulled out due to changes in the patient's position, and liquefied feces leaking out from the gap between the insertion tool and the anus. can do.

Therefore, the defecation treatment of patients with defecation disorders is always safe and secure.
Since it can be completed reliably and within a short period of time, medical effects can be brought about that can significantly reduce the physical and mental burden on patients, practitioners, and caregivers during treatment.

[Brief explanation of the drawing]

Fig. 1 is a partially cutaway N cross-sectional view showing a state in which an insertion tool according to an embodiment of the present invention is inserted into the rectum from the anus, and Fig. 2 shows a state in which the telescoping means of the insertion tool is extended in Fig. 1. FIG. 3 is an overall configuration diagram showing a conventional inserter, and FIG. 4 is an enlarged front view (a) and a cross-sectional view of the tip of the horn in FIG. 3. Figure (b), fifth
The figure is an overall configuration diagram of an excretion treatment device to which an insertion tool is attached. l... Horn 2... Vibrator 3... Protective cover 4... Suction nipple 5... Iri
6...Irrigation nipple 7...
Cable 8...Suction hole 9...0-ring 1
0...Fixing plate 11...O-ring 12...Blowout hole 13...Irrigation silane hole 14...Suction pump 15...Storage container 16...Suction tube 17...Occillator 18.・Cleaning liquid container I9・・
・Irrigation pump 20...Preheater 21...Irrigation tube 22...Anus 23...Rectum 24...Extensible means 25...Body case 26...Spring 27...
- Cut groove 28...Lock lever 29...Ring-shaped balloon

Claims (1)

[Scope of Claims] 1. An insertion device that is attached to an excretion processing device that crushes and suctions out feces by inserting a horn that vibrates mechanically using ultrasonic waves into the rectum through the anus, the vibrator being installed in the system. and an inserter for an excrement disposal device, characterized in that an extensible means for moving a vibrating section consisting of a horn back and forth is provided. 2. The insertion tool for an excretion treatment device according to claim 1, wherein a gas-liquid expandable ring-shaped balloon is installed on the outer periphery of the protective cover to be inserted into the anus. 3. The insertion device for an excrement disposal device according to claim 1 or 2, wherein a trapezoidal ring-shaped pad is slidably installed at a position on the tip side of the horn immediately before the suction nipple on the outer periphery of the protective cover.